This invention pertains to a method and apparatus for fixing bone fractures and in particular to such a method and apparatus for fixing long bone fractures. While it is particularly adapted for use with phalangeal fractures, it may also be used in other long bones.
Of the many techniques that have been developed for fixing transverse bone fractures, none have been satisfactory for fixing such fractures in the phalanges. Several devices such as intramedullary rods and marrow nails have been successfully used on larger bones, such as the leg bones. However, all such devices have significant drawbacks that prevent their uses in smaller bones.
In an intramedullary fixation device disclosed in U.S. Pat. No. 3,709,218 issued to Halloran, the device is driven throughout the length of a femur and occupies the entire intramedullary canal. The rod is inserted at the fracture site and must be driven through the canal, out the upper end of the femur and into the buttock in order to effect insertion. If a compression plate is to be used in association with the intramedullary rod, preformed slots in the rod must be identified by x-ray and holes made through opposing walls of the bone aligned with the slots. Screws are passed through the plate, the rod and both walls of the bone. Such a device would be wholly inappropriate in fixing a phalangeal fracture for apparent reasons.
Due to the intricate balance of tendinous units and the lack of soft tissue coverage in the phalanges, these bones are additionally not particularly suitable for other known fixation techniques such as an external compression plate fastened to the periosteal cortex. The plate interferes with the surrounding soft tissues preventing satisfactory early movement, etc. Although Kirschner wires have been used to adequately control many types of phalangeal fractures, the end of the wire also has a tendency to interfere with the surrounding soft tissue. The wires, additionally, often fail to produce a solid fixation of the fracture, particularly transverse phalangeal fractures. This type of fracture is extremely difficult to fix while allowing early range of motion.